The pancreas is a gland located deep in the abdomen between the stomach and the spine. The pancreas performs exocrine and endocrine functions. Its exocrine functions include secreting pancreatic juice containing digestive enzymes into the digestive tract. Its endocrine functions include producing hormones such as insulin, glucagon, and somatostatin, for controlled release into the bloodstream.
Chronic pancreatitis is an inflammatory condition that results in permanent structural changes in the pancreas. Clinical manifestations of this disorder include chronic abdominal pain and pancreatic exocrine and endocrine dysfunction.
One theory regarding the pathogenesis of chronic pancreatitis suggests that increased secretion of pancreatic proteins causes proteinaceous plugs to form within the interlobular and intralobular ducts of the pancreas. These plugs may acts as a nidus for calcification, leading to stone formation within the duct system. The net result is the formation of ductal epithelial lesions which scar and obstruct the pancreatic ducts, thereby causing inflammatory changes and cell loss.
When a patient suffers from a pancreatic or biliary duct obstruction, such as those encountered with pancreatitis, the production of pancreatic enzymes may be a damaging and painful process. Since there is a hindrance of the natural passage of these enzymes into the GI tract, digestive juices may build up within the pancreas, causing ductal distension, tissue damage, and pain. Due to the increased pressure in the duct, the fluid may seek alternate, unnatural routes for release, which may lead to the development of fissures in the pancreas. These fissures may leak pancreatic enzymes that digest surrounding tissues and organs and thereby cause severe abdominal pain and organ damage.